Abstract
BackgroundThe National Comprehensive Cancer Network guidelines recommend intensity-modulated radiotherapy (IMRT) as primary curative treatment for newly diagnosed nasopharyngeal carcinoma (NPC), but the radiation-related complications and relatively high medical costs cannot be ignored. We examined whether endoscopic nasopharyngectomy (ENPG) could be an effective alternative treatment for localized stage I NPC. MethodsTen newly diagnosed localized stage I NPC patients received ENPG alone from June 2007 to September 2017 in Sun Yat-sen University Cancer Center. The survival outcomes, quality of life (QOL), and medical costs were collected. Simultaneously, data for 329 stage I NPC patients treated with IMRT were collected as a reference. ResultsAfter a median follow-up of 59.0 months (95%CI 53.4-64.6), no death, locoregional recurrence, or distant metastasis was observed in the 10 ENPG-treated patients. The 5-year overall survival, local relapse-free survival, regional relapse-free survival and distant metastasis-free survival among the ENPG-treated patients was similar to that among the IMRT-treated patients (100% vs. 99.1%, 100% vs. 97.7%, 100% vs. 99.0%, 100% vs. 97.4%, respectively, P > 0.05). In addition, compared with IMRT, ENPG was associated with decreased total medical costs ($4090.42±1502.65 vs. 12620.88±4242.65, P < 0.001) and improved QOL scores including dry mouth (3.3±10.5 vs. 34.4 ± 25.8, P < 0.001) and sticky saliva (3.3±10.5 vs. 32.6 ± 23.3, P < 0.001). ConclusionsENPG alone was associated with promising long-term survival outcomes, low medical costs, and excellent QOL and might therefore be an alternative strategy for treating newly diagnosed localized stage I NPC patients. Legal entity responsible for the studyMingyuan Chen. FundingNational Natural Science Foundation of China. DisclosureAll authors have declared no conflicts of interest.
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